The difficulty of postural tasks amplifies the effects of fatigue on postural stability.

PURPOSE: It was supposed that the difficulty of postural tasks accentuates the effects of fatigue on postural stability. The aim of this work was to compare the effects of fatiguing running on three different postural conditions presenting different levels of difficulty: a standing still position with the eyes open (EO condition), a standing still position with the eyes closed (EC condition) and a shooting position with the eyes open (SP condition). The SP condition required a rifle to be held horizontally with the arms and a standing posture with the non-dominant foot ahead of the dominant foot. METHODS: Thirty-two male soldiers 32.2 ± 3.8 years old completed a maximal incremental protocol on a treadmill by running until they reached a state of fatigue. The three postural conditions were evaluated in a randomized order before and after the fatiguing exercise with the use of a force platform which recorded the displacements of the centre of foot pressure. RESULTS: Following the fatiguing running exercise, postural stability was affected to a greater extent in the SP condition than in the EO condition and the EC condition. CONCLUSION: The requirements of the SP condition modify the entire postural organization and this challenges balance control to a greater extent than when in EO and EC standing still positions, following fatiguing exercise. The difficulty of postural tasks thus amplifies the effects of fatigue on postural stability.

Towards a personalized health care using a divisive hierarchical clustering approach for comorbidity and the prediction of conditioned group risks.

The objective was to assess risk of hospitalization and mortality of comorbidities using divisive hierarchical risk clustering to advice clinical interventions. Subjects and Methods: Data from the EHR of a general population, 3799885 adults, followed by 5 years. Model were performed using Spark and Scikit-learn and accuracy for the models was analyzed. Results: The number of models generated depends in part on the number of chronic diseases included (ex testing a sample of six diseases, a total number of 397 models for all-cause mortality and 431 models for hospitalization). The estimated models offered an ordered selection for the relevant clinical variables and their estimated risk as a group and for the individual patient in the group. Accuracy was assessed according to age, sex and the cardinality of the comorbid groups. A mobile version and dashboard were developed. Conclusion: The software developed stratified hospital admission and mortality risk in clusters of chronic diseases, and for a given patient, it could advise intensifying treatment or reallocating the patient risk.

Supervised physical activity in patients with symptomatic peripheral arterial disease: protocol for a randomized clinical trial (ARTPERfit Study).

INTRODUCTION: Peripheral arterial disease (PAD) is a marker of cardiovascular morbidity, causing disability, loss of mobility and poor quality of life, manifesting clinically in the form of intermittent claudication (IC). Physical exercise increases the distance walked and improves quality of life. The aim of our study will be increased walking distance prolonging the time of onset of pain in patients with symptomatic PAD (IC). METHODS AND ANALYSIS: This study will be performed in Mataró Hospital's vascular surgery service and School of Health Sciences, TecnoCampus. This population comes from 15 primary healthcare centres ofNorth Barcelona, Spain (450 000 inhabitants).This study will be a four-group parallel, longitudinal, randomised controlled trial, blind to analysis.The main primary outcome of this study will be the improvement in pain-free walking distance. Others primary objectives are and improvement in functional status, quality of life and Ankle-Brachial Index (ABI). Secondary outcomes will be the analysis of cardiorespiratory fitness, evaluation of muscle fitness, determine the maintenance of primary objectives at 6 and 12 months.We will be included 124 patients (31 per group). The changes of the outcome (Barthel, SF-12, VascQOL-6, ABI) of the three intervention groups vs the control group at 3, 6 and 12 months will be compared, both continuously (linear regression) and categorically (logistic regression). A person who has not performed at least 75% of the training will be considered to have not completed the intervention. ETHICS AND DISSEMINATION: The study will be conducted according to the Declaration of Helsinki . It was approved by the Ethics Committee of the Research Institute Primary Health IDIAP Jordi Gol (20/035 P),Barcelona 6 October 2020. Informed consent will be obtained from all patients before the start of the study. We will disseminate results through academic papers and conference presentations. TRIAL REGISTRATION NUMBER: NCT04578990.

Relation between physical activity and academic performance in 3rd-year secondary education students.

The main aim of this study was to analyze the relationship between the amount of physical activity and academic performance in 3rd-year secondary education students. The sample was taken from three secondary schools in the area of Barcelona. 284 students (158 girls, 126 boys) with an average age of 14.7 yr. participated. The International Physical Activity Questionnaire was used by students to self-report their amount of physical activity. Students' academic records were obtained for comparisons. Results showed that there was a linear relationship between academic performance and physical activity; nevertheless, there was a trend to stronger correlation when modeling the relationship between these variables with a quadratic equation. Further research should focus on whether academic performance and physical activity might be better explained with a second-order equation.

Effects of electrical stimulation on muscle trophism in patients with hemophilic arthropathy.

OBJECTIVE: To determine changes occurring in the cross-sectional area, electromyography (EMG) activity, and the strength of the biceps brachii after an 8-week period of bilateral training with surface muscle electrical stimulation in patients with hemophilic arthropathy. DESIGN: Controlled trial. SETTING: Coagulopathy unit, university hospital. PARTICIPANTS: Volunteer subjects (N=30) participated in this study: 15 with severe hemophilia A (hemophilic group) and 15 nonhemophilic control subjects (control group). INTERVENTIONS: The hemophilic group followed a surface electrical stimulation program (frequency 45 Hz, impulse 200 micros, 10s on/10s off) over an 8-week period on the biceps brachii of both arms. The control group did no training of any kind. MAIN OUTCOME MEASURES: The cross-sectional area, maximum voluntary isometric contraction, and EMG activity of the biceps brachii in both arms were determined before and after the 8-week-long task. RESULTS: The results of the hemophilic group showed significant increases in the diameter (15.8%, P<.001), isometric force (4.6%, P<.05), and EMG activity (37.6%, P<.05) of the biceps brachii muscles in both arms. No significant changes were observed for the control group. CONCLUSIONS: Our findings confirm the efficacy of muscle electrical stimulation in causing muscles to hypertrophy in patients with hemophilia, thereby improving their muscular strength. In addition, these results may also be clinically applicable in the rehabilitation of patients who have similar deficiencies in the locomotor system.

Cross-education after one session of unilateral surface electrical stimulation of the rectus femoris.

Thirty-six adult men were randomly assigned to a remote stimulation group (RS; n = 18) or control group (CTL; n = 18). The RS group unilaterally performed a 10-minute surface electrical stimulation program (frequency 100 Hz, impulse 300 micros, 10 seconds on/10 seconds off) on the rectus femoris of the non-dominant leg. The subjects of the CTL group relaxed for 10 minutes without performing any training. Immediately before and after the surface electrical stimulation program, the isometric strength and the electromyographic (EMG) and mechanomyographic (MMG) response of the dominant leg was measured for all subjects. The dominant leg of the RS group showed a significant increase in the isometric force (5.11%; P < 0.001) and EMG activity of the agonist muscle (4.67%; P < 0.05), whereas a decrease in EMG activity of the antagonist muscles was observed (-10.27%; P < 0.05). The MMG activity did not show any alteration. No significant changes were observed for the CTL group. These results indicate that one unilateral surface electrical stimulation session on the rectus femoris improves the efficiency of the inactive leg. At a practical level, the results open a new way to rehabilitate muscle-skeletal injuries, especially weak members that cannot do any physical work. In this case, the muscle strength (and physical efficiency) can be improved by passive electrostimulation training on the healthy member.

How whole-body vibration can help our COPD patients. Physiological changes at different vibration frequencies.

OBJECTIVE: Evaluate cardiac, metabolic, and ventilatory changes during a training session with whole-body vibration training (WBVT) with 3 different frequencies in patients with chronic obstructive pulmonary disease (COPD). METHODS: This was a prospective, interventional trial in outpatients with severe COPD. Participants performed 3 vertical WBVT sessions once a week using frequencies of 35, 25 Hz and no vibration in squatting position (isometric). Cardiac, metabolic, and ventilator parameters were monitored during the sessions using an ergospirometer. Changes in oxygen pulse response (VO2/HR) at the different frequencies were the primary outcome of the study. RESULTS: Thirty-two male patients with a mean forced expiratory volume in 1 second of 39.7% completed the study. Compared to the reference of 35 Hz, VO2/HR at no vibration was 10.7% lower (P=0.005); however, no statistically significant differences were observed on comparing the frequencies of 35 and 25 Hz. The median oxygen uptake (VO2) at 25 Hz and no vibration was 9.43% and 13.9% lower, respectively, compared to that obtained at 35 Hz (both comparisons P<0.0001). The median expiratory volume without vibration was 9.43% lower than the VO2 at the end of the assessment at 35 Hz vibration (P=0.002). CONCLUSION: Vertical WBVT training sessions show greater cardiac, metabolic, and respiratory responses compared with the squat position. On comparing the 2 frequencies used, we observed that the frequency of 35 Hz provides higher cardiorespiratory adaptation.

Preguntas y respuestas sobre infecciones de prótesis articulares / Questions and answers about a artificial joint infections

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